Interpupillary Distance Constraints in Pediatric VR: Implications for Psychology and Psychotherapy

TL;DR

This paper highlights how interpupillary distance constraints in consumer VR headsets can affect children’s visual experience and engagement in pediatric psychology and psychotherapy, emphasizing the need for better headset design considerations.

Contribution

It identifies IPD constraints as a significant, underrecognized issue in pediatric VR research and therapy, advocating for treating headset fit as a critical methodological factor.

Findings

IPD mismatch likely affects younger children and those with smaller IPD.

Headset fit influences visual comfort, depth perception, and engagement.

Pediatric VR research should consider headset compatibility as a core methodological aspect.

Abstract

Virtual reality (VR) is increasingly used across psychology, from research and assessment to counseling, psychological treatment, and psychotherapy, with growing applications for children and adolescents. In these contexts, VR is often treated as a relatively neutral delivery medium. This assumption may be misleading. Most consumer head-mounted displays (HMDs) have been designed primarily for adult anthropometry, including adult interpupillary distance (IPD) ranges. As a result, some children may be excluded from participation or may receive a systematically degraded perceptual experience because the device cannot be adequately aligned to their visual anatomy. This paper argues that IPD constraints in consumer VR headsets represent an underrecognized methodological and clinical problem in pediatric psychology and psychotherapy. If headset fit affects visual comfort, depth perception, attentional load, cybersickness, willingness to remain in the simulation, and sense of presence, it may also influence engagement, emotional processing, dropout, and treatment response. The headset may therefore function as a selection mechanism, shaping who is included in studies, who can tolerate intervention, and to whom findings can be generalized. Using published developmental IPD data, official headset specifications, and examples from pediatric and youth-oriented VR studies, we show that anthropometric mismatch is likely to disproportionately affect younger children and those at the lower end of the IPD distribution. Using Meta Quest 3 as a case study, we argue that pediatric VR research and therapy should treat headset compatibility as part of psychological method rather than as background technical detail.